1. Responsiveness of depression and its influence on surgical outcomes of lumbar degenerative diseases.
- Author
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Falavigna A, Righesso O, Teles AR, Conzati LP, Bossardi JB, da Silva PG, and Cheng JS
- Subjects
- Adult, Depression complications, Female, Follow-Up Studies, Humans, Intervertebral Disc Displacement complications, Male, Middle Aged, Patient Satisfaction, Postoperative Period, Preoperative Period, Prevalence, Prospective Studies, Psychiatric Status Rating Scales, Quality of Life, Risk Factors, Sex Factors, Spinal Stenosis complications, Spondylolisthesis complications, Treatment Outcome, Depression epidemiology, Intervertebral Disc Displacement surgery, Lumbar Vertebrae, Spinal Stenosis surgery, Spondylolisthesis surgery
- Abstract
Objective: To demonstrate the responsiveness of depression after surgery for lumbar degenerative disease and to verify the impact of this condition on surgical outcomes., Patient Sample: A prospective cohort study with 91 patients with lumbar degenerative diseases who were evaluated preoperatively, at 30 days and 1 year postoperatively., Outcome Measures: Evolution of depression between the follow-ups and its correlation with satisfaction., Methods: Depression was assessed with Beck Depression Inventory. According to depression responsiveness, patients were classified into four groups: NN = no depression; ND = normal during the preoperative period and depression within 1 year; DN = depression during the preoperative period and normal within 1 year; DD = depression during the preoperative period and within 1 year., Results: Prevalence of preoperative depression was 28.6% and 17.6% within 1 year postoperatively. Most patients (65.4%) with depression in the preoperative period recovered postoperatively. Poor preoperative HRQoL measures were associated with higher rates of responsiveness of depression during the follow-up. Patients with depression at the 1-year postoperative follow-up had a worse functional outcome. Patients who improved from depression had similar outcome to those without depression. Dissatisfaction within 1 year postoperatively was greater in patients who become depressed after surgery and remain depressed at 1-year follow-up (NN = 8.8%; ND = 42.9%; DN = 17.6%; DD = 44.4%; P = 0.012)., Conclusion: Most patients with depression in the preoperative recover within 1 year postoperatively. Responsiveness of depression is associated with surgical outcomes. The presence of depression after the surgical treatment, independent of when it starts, had a major negative impact on prognosis.
- Published
- 2015
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